A two-day hospital stay in a California-based hospital gave our bill review team some serious heart palpitations – not from medical concerns, but from the staggering charges.
The hospital, known for its hefty billing practices, submitted charges of $133,542 for just two days of care. Let’s break that down:
- $39,950 for two days of room and board: one day in the coronary care unit (CCU) and one day in the intensive care unit (ICU).
- $33,088 for 75 lab tests, for an average charge of $441 per test.
- $17,438 for emergency room services.
- No major surgeries or intensive treatments took place beyond routine scans and respiratory services.
At WellRithms, we know that healthcare reimbursement should reflect the true cost of providing services and a reasonable margin, not blatantly inflated price tags. Our proprietary technology, paired with the expertise of our medical review team, scrutinized this bill using facility cost reports and data-driven algorithms. The result? We repriced the charges to $19,836, which amounts to just 14.9% of the original billed amount.
This repriced figure represents the actual cost of care, plus a profit for the provider, ensuring a fair and defensible payment for the patient, hospital, and the payor.
At WellRithms, we’re committed to protecting employers and payors from unjustified medical overbilling, one bill at a time.
For more information on how WellRithms can help you reduce inflated healthcare costs and prevent overpayment on high-cost claims, contact info@wellrithms.com.
